Preop Eval 4.4 - App Store

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About Preop Eval

Preop Eval organizes and presents much of the guidance that one needs in order to evaluate and prepare adult patients for non-cardiac surgery. It is based upon the guidelines on this topic from the American College of...

Preop Eval organizes and presents much of the guidance that one needs in order to evaluate and prepare adult patients for non-cardiac surgery. It is based upon the guidelines on this topic from the American College of Cardiology, the European Society of Anaesthesiology, the American Society of Anesthesiologists, the Institute for Clinical Systems Improvement, the American College of Chest Physicians, and more (full references in the app). The app contains 1 algorithm and 3 resources: the cardiac evaluation algorithm, guidance on starting and stopping key medications in the perioperative period, guidance on timing of surgery after cardiac events, and guidance on preoperative testing. It also contains a review of preoperative evaluation mainly for students and residents. The app addresses such common questions as: - who needs bloodwork before surgery? - who needs an EKG or a CXR? - how do I handle patients on warfarin, clopidogrel, and DOAC's? - which patients need adjustment of perioperative insulin and diabetic meds, and how? - which active cardiac conditions preclude surgery? - how long after MI or stent should a patient wait before surgery? - are there adjustments to make on psych meds, rheumatologic meds, ACE's and ARB's? This app is written and intended for practicing physicians like internists, family physicians, and hospitalists; for resident physician trainees; and for medical students. In addition to being a reference, the algorithm is written to be a teaching tool by not just delivering an answer, but instead walking a physician through the evaluation process so that one learns that process along the way. As an educator and clinician, I am interested in feedback and I would be grateful for guidance on improving the tool.

Version History - updated guidance on perioperative buprenorphine - perioperative fasting (food and drink) - perioperative GI meds as related to avoiding aspiration - ASA physical status classes and recommendations from ASA on preop testing for class I & II undergoing low risk surgery - preop urinalysis clarification based upon IDSA guideline 4.4 11/05/2025 added guidance on additional medications: herbals, vitamins, supplements, and cannabinoids 4.3 08/26/2025 Significant updates on perioperative GLP-1 use, more data on SGLT-2's perioperatively, and additional evidence on perioperative ACE-ARB's 4.2 03/06/2025 Dysfunctional graphic for DOAC interruption low-mod risk patients fixed. That's it! 4.1.1 03/04/2025 Updated the guidance from ACC-AHA 2024 and ACCP 2022 guidelines on all anticoagulants (VKA, DOAC) and antiplatelet agents (aspirin, clopidogrel, etc.). 4.1 12/15/2024 Updating the entire app for the 2024 ACC-AHA guideline, for now, changed stuff has new gray color scheme. Clearer, more detailed guidance on perioperative DOAC mgmt based upon most recent evidence. Might go all the way and add/edit all anticoag/antiplatelet agent guidance now that it is contained entirely within the ACC-AHA guideline of 2024. Thinking about it. Lotsa work, not sure I can handle the conceptual complexity. I will get DOAC's done. 4.0 12/08/2024 Updated for guideline and evidence on timing of surgery after stroke 3.0 07/19/2022 Updated guidance on perioperative management of buprenorphine (and suboxone) consistent with the multi-society expert panel recommendations from Regional Anesthesia Pain Medicine 2021. 2.9 11/19/2021 - updated preop EKG recommendations - reorganized guidance on periop blood thinners (anticoag, anti platelet) mainly linking to excellent external sources since the topic has become so complicated - added guidance on periop DOAC's - updated for latest iOS standards 2.8 01/17/2021 New content from the medical literature: - updated for FDA guidance on perioperative SGLT-2 inhibitor management 2.7 03/19/2020 Lots of new medical content from recent medical literature! - perioperative anti-rheumatologic med mgmt - periop buprenorphine/suboxone mgmt - pre and postop BNP & Troponin testing - how long to wait after PCI - periop NSAID mgmt This update does NOT include new material on all things that make ya bleed like Warfarin, bridging Heparins, Aspirin, Plavix, DOAC's, etc. That's coming in the next update. 2.6 01/15/2020 - turned references listings into hotlinks direct to original documents or to PubMed - hotlink for feedback email 2.5 12/03/2016 - updated evidence on Warfarin and bridging Heparins - updated evidence on periop ACE's/ARB's 2.4 11/30/2016 reference to the 2007 ACC cardiac evaluation algorithm added back for those who liked it and want to compare to the 2014 approach 2.3 02/28/2015 minor bug fixes 2.02 01/02/2015 updated info for 2014 ACC guideline, added more preop testing guidance from ESA & ASA, and more works with iOS 8 (yay!) 2.01 12/30/2014 Updated with relevant contributions from the ACCP 9th edition Antithrombotic & Thrombolytic Therapy Guideline of February 2012 1.4 08/20/2012 added guidance on perioperative management of diabetes medications courtesy the ICSI guideline 1.3 11/20/2011 updates from more recent guidelines (e.g. ICSI) and typo fixes 1.2 10/31/2011 cosmetic improvements 1.01 01/05/2011 1.0 06/01/2010

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Previous Versions

Here you can find the changelog of Preop Eval since it was posted on our website on 2016-09-30 18:14:31. The latest version is 4.4 and it was updated on 2026-07-01 10:54:02. See below the changes in each version.

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